Yesterday, we relayed the framework and fodder of a discussion we co-hosted with the Committee for Economic Development and Better Health Care Together on the business case for health reform. Today, we'll focus on the discussion.

First, a brief recap: the discussion centered on a new analysis by the McKinsey Global Institute (MGI) on U.S. health care spending.

Basically the U.S. spends a lot on health care—$2.1 trillion in 2006. That's more than all the citizens of China spent on personal consumption, according to McKinsey. This spending doesn't just reflect that health care is a normal good and that when income increases we tend to spend more. At least $650 billion of our spending cannot be explained by greater levels of wealth. Instead, it seems the way we pay for and deliver health care in the U.S. creates incentives for inefficiencies, overuse, and excess spending.

The discussion portion of this event, moderated by the Center for American Progress's Matt Miller, took up two basic questions. First, what do these figures mean? Second what do we do about it?

McKinsey's Lenny Mendonca, who presented the findings, likened the greater than expected spending to a built in de-stimulus on the economy, borne in large part by business.

Lois Quam of the consulting firm Piper Jaffray emphasized that this burden fell hardest on small business and that health care had become an barrier to entrepreneurship and job creation. Individuals shouldn't have to choose between starting a business and maintaining coverage for themselves and their family.

Carl Camden, CEO of Kelly Services, provided some fascinating insights into health care's effects on competition and the labor market. Wage gaps between college-educated labor in the U.S. and other developed countries have shrunk, while the benefit gaps had actually grown. Increasingly, the cost of benefits like health care is a deciding factor in where a company chooses to locate jobs.

For potential solutions,the care panel turned to members of the Health CEOs for Health Reform, a diverse coalition of health care leaders who share a unique willingness to transform their business models to create a more sustainable health system.

Patricia Gabow, MD, CEO of Denver Health, laid out the failings of our current system from the unique perspective of Denver's largest safety net provider and emphasized the need for physician leadership to achieve a solution. (Gabow's own leadership in her community recently caught the eye of Denver's Rocky Mountain News, which named her one its "people to watch" for 2009)

In prepared remarks delivered via video, Gary Kaplan, MD, chairman and CEO of Virginia Mason Medical Center, talked about how his organization has applied the management methods of the Toyota Way to achieve more integrated, higher quality care.

Nicholas Wolter, MD, CEO of the Billings Clinic also emphasized the need for more coordinated models of care, and talked about the potential of bundled payments and other delivery system reforms to realign incentives for quality care.

Our colleague, Joanne Kenen, just posted a piece suggesting that all the "happy talk" surrounding health reform this time around might actually get us somewhere. We think having health care providers, business, and labor all in the same room talking constructively about how to fix the system most certainly qualifies as a conversation to be happy about.